RCMS Occupational Safety

Job Safety Analysis (JSA) Form

SAF_32_JSA FORM_01
SECTION A: JOB DESCRIPTION: Civil Work - Construction of ISO Staging Concrete Work, The Installation of Street Light
LOCATION: AROMA DATE: 21/7/2019
CONTROLS & SAFETY PRECAUTIONS
No BASIC JOB STEPS No POTENTIAL HAZARDS No (Specify person whom responsible for
implementing the “Control & Safety
Precautions)
1 Preparation PTW 1.1 Wrong location / Wrong interpretation 1.1.1 - Site visit with area owner (Aroma) and
project owner (LG 2.0) the area to confirm
the work scope and location.
1.1.2 - Clearly inform in the permit to work the
agreed job scope
1.1.3 - Receiving Authority (RA) to brief the job
scope to the permit issue in detail before
1.1.4 execution
- Permit Receiver to conduct site safety
briefing SSB to all workers before work
execution at work place and make sure SSB
BEEN fully fill after briefing
2 Mobilization to site/demobilization from 2.1 Moving machinery 2.1.1 - Apply Permit (Hot Work)
site. (Transferring material/equipment 2.1.2 - Competence or certified forklift/lorry
from/to workshop/site) driver.
(Forklift, Lorries) 2.1.3 - Make sure working area free from
pedestrian and warning sign display.
2.1.4 - Traffic controller/flagman with a reflector
west must be at site and control traffic
when execution the job.
2.1.5 - Material and tool is stack and keep at safe
place and proper storage.
2.1.6 - Make sure machinery/vehicle been
inspected by BPC to have a valid inspection
sticker.
2.2 Fire Ignition 2.2.1 - Permits are checked for its validity- Hot
Work permit
2.2.2 - Placed fire extinguisher at work site with
valid inspection sticker by BPC. Fire and
Bomba dept
2.2.3 - Spark Arrester should be installed at the
machine
2.2.4 - LEL must be checked by operations before
work start and it must show 0%
2.2.5 - STOP work if reading is more then 0%
LEL and inform the area owner
2.3 Ergonomics (Manual Lifting) 2.3.1 - Body posture in correct position
2.3.2 - Rotate worker and comply BPC fatigue
management
2.3.3 - Buddy system
2.4 Sharp edges/Pinch point 2.4.1 - Workers to wear semi-leather glove
2.4.2 - Remove blunt or sharp object from work
area
2.4.3 - Make sure hand/body position not in pinch
point location.
2.4.4 - Ensure housekeeping done
3 Manual excavation work for the concrete 3.1 Underground pipe or electrical cable. 3.1.1 - Attached Scanning report with the JSA

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 pavement slab along with SSB in the PTW
Dept: 250mm 3.12 - Stop work if any cables were detected while
digging and inform the area owner
3.2 Ergonomics 3.2.1 - Manual lifting only for small and light
material not more than 25kg per person.
3.2.2 - Buddy system
3.2.3 - Make sure body posture in correct position
3.2.4 - Rotate worker and comply BPC fatigue
management
3.3 Sharp edges/Pinch point 3.3.1 - Workers to wear semi-leather glove
3.3.2 - Remove blunt or sharp object from work
area
3.3.3 - Make sure hand/body position not in pinch
point location.
3.3.4 - Ensure housekeeping done
3.4 Dust 3.4.1 - Make sure to wear dust mask N95
3.4.2 - Have a Rinsing / Wetting Mechanism
3.5 Heat 3.5.1 - Rest in between the work (Follow bpc
fatigue management practice) not exceed 6
day of working
3.5.2 - Rest in between the work (Follow bpc
fatigue management practice) not exceed 6
day of working
3.5.3 - Rotate workers from long duration of work
3.5.4 - workers to drink a lot water during hot
weather
3.6 Open edge 3.6.1 - Hard Barricade and signage
4 Excavation work for concrete pavement 4.1 Moving machinery 4.1.1 - Apply Excavation Permit-Purple color
slab using backhoe (250mm depth) 4.1.2 - Competence or certified backhoe/lorry
driver.
4.1.3 - Make sure working area free from
pedestrian and warning sign display.
4.1.4 - Traffic controller/signalman with
signalman west must be at site and control
traffic when execution the job.
4.1.5 - Material and tool is stack and keep at safe
place and proper storage.
4.1.6 - Make sure machinery/vehicle been
inspected by BPC to have a valid inspection
sticker.
4.2 Electrocution- cables underground 4.2.1 - Run an underground test/detection before
starting work to make sure no electrical
cable underground or pipe.
4.2.2 - Attached a scanning report to JSA and
PTW
4.2.3 - Stop work immediately if underground
cable or pipe is found during excavation
work
4.3 Open edges/holes 4.3.1 - Install hard barricade and put warning
signage around the excavate area
4.3.2 - Material and tool is stack and keep at safe
place and proper storage.
4.3.3 - Provision for temporary shoring/strutting
4.4 Sharp edges/Pinch point 4.4.1 - Workers to wear semi-leather glove
4.4.2 - Remove blunt or sharp object from work
area
4.4.3 - Make sure hand/body position not in pinch

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 point location.
4.4.4 - Ensure housekeeping done
5 Water pump activities during rainy season 5.1 Fire Ignition 5.1.1 - Permits are checked for its validity- Hot
during excavation period (operation of Work permit
diesel pump) 5.1.2 - Firewatcher to be full time must standby at
work site during job execution and be
certified and approved by bpc fire and
bomba dept and be endorse competency in
BPC Safety passport
5.1.3 - Placed fire extinguisher at work site with
valid inspection sticker by BPC. Fire and
Bomba dept
5.1.4 - Spark Arrester should be installed water
pump
5.1.5 - lEL must be checked by operations before
work start and it must show 0%
5.2 Oil spillage 5.2.1 - Maintenance with regards to compactor
5.2.2 - Ubf to do daily visual checking before of
after work
5.2.3 - Inspection by bpc mechanical team and
have a valid inspection sticker
5.2.4 - Drip tray to be put under the compactor to
avoid spillage and to prepare absorption
pads
5.2.5 - Ensure a proper storage, signage and
labeling
6 Pouring the concrete using a tipper truck 6.1 Moving machinery- tipper truck and 6.1.1 - Tipper truck to inspected by UBF
and compact the crusher run using a baby baby compactor Supervisor before entry
roller 1T/roller compactor 6.1.2 - Baby compactor must be inspected and be
given a valid inspected sticker by BPC
before use
6.1.3 - A short video briefing at the
BPC Security office before entry for the
lorry driver and a safety induction for the
operator that are using the baby compactor
6.1.4 - Flagman with reflector must coordinate the
movement of the truck will in site
6.1.5 - Materials are kept and stack in a designated
area given by owner with signage and
barricade
6.1.6 - Materials are not to be stacked at the
walkway or excess
6.2 Ergonomics 6.2.1 - Manual lifting only for small and light
material not more than 25kg per person.
6.2.2 - Buddy system
6.2.3 - Make sure body posture in correct position
6.2.4 - Rotate worker and comply BPC fatigue
management
6.3 Concrete spillage-Cement/Dust 6.3.1 - Workers are to be worn Dust Mask n95 and
all nearby people
6.3.2 - Barricade working area and put warning
sign
6.4 Heat 6.4.1 - Rest in between the work (Follow bpc
fatigue management practice) not exceed 6
day of working
6.4.2 - Rotate workers from long duration of work
6.4.3 - workers to drink a lot water during hot
weather
6.5 Electrocution- cables underground 6.5.1 - Run an underground test/detection before

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 starting work to make sure no electrical
cable underground or pipe.
6.5.2 - Attached a scanning report to JSA and
PTW
6.5.3 - Stop work immediately if underground
cable or pipe is found during excavation
work.
6.6 Open edges/holes 6.6.1 - Install hard barricade and put warning
signage around the excavate area
6.6.2 - Material and tool is stack and keep at safe
place and
proper storage.
6.6.3 - Provision for temporary shoring/strutting.
6.7 Land slides 6.7.1 - Provision of temporary shoring-wall plate
secured with wall hooks , cleats and needles
6.7.2 - Barricade and signage
6.8 Oil spillage 6.8.1 - Maintenance with regards to compactor
6.8.2 - Ubf to do daily visual checking before of
after work
6.8.3 - Inspection by bpc mechanical team and
have a valid inspection sticker
6.8.4 - Drip tray to be put under the compactor to
avoid spillage and to prepare absorption
pads
6.8.5 - Ensure a proper storage, signage and
labeling
7 Installation/Dismantlation of rebar and 7.1 Damaged tools 7.1.1 - Permits are checked for its validity upon
formwork (Manual Work) starts of work
7.1.2 - UBF Supervisor to do visual inspection to
all equipment before using
7.1.3 - No modification of tools, no misuses, faulty
must be avoided. (NO adjustable spanner to
be used at site)
7.1.4 - To make sure workers well trained to use
the equipment and tool.
7.2 Ergonomics 7.2.1 - Manual lifting only for small and light
material not more than 25kg per person.
7.2.2 - Buddy system
7.2.3 - Make sure body posture in correct position
7.2.4 - Rotate worker and comply BPC fatigue
management
7.3 Pinch point /Protruding Nails 7.3.1 - Worker are to be worn leather glove during
work
7.3.2 - Remove blunt or sharp object from work
area
7.3.3 - Make sure hand/body position not in pinch
point location.
7.3.4 - Bend the nail/remove from the formwork
- Ensure housekeeping done
8 Concreting work using concrete bucket by 8.1 REFER TO THE GENERIC LIFTING 8.1.1 REFER TO THE GENERIC LIFTING JSA-
lifting crane 45t and concrete vibrator
using diesel JSA- LIFTING USING CRANE LIFTING USING CRANE
9 9.1 Ergonomics-concrete vibrator 9.1.1 - Manual lifting only for small and light
material not more than 25kg per person.
9.1.2 - Buddy system
9.1.3 - Make sure body posture in correct position
9.1.4 - Rotate worker and comply BPC fatigue
management

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 9.2 Fire Ignition-Diesel use-concrete
vibrator
10 To perform installation of 6 units of street 10.1 REFER TO THE GENERIC LIFTING
lights pre-cast foundations
JSA- LIFTING USING CRANE
11 Installation street light pole involving 11.1 REFER TO THE GENERIC LIFTING
manual bolt connection
JSA- LIFTING USING CRANE
11.2 Ergonomics
12 Excavation cable trenching of the dept 12.1 Moving machinery
900mm by using backhoe (900mm depth)
12.2 Electrocution- cables underground
12.3 Open edges/holes
12.4 Sharp edges/Pinch point
13 Working at Night 13.1 Inadequate lighting
9.2.1 - Permits are checked for its validity- HWP
9.2.2 - Vibrator must be inspected and be given to
bpc for its validity tagging.
9.2.3 - Firewatcher to be full time must standby at
work site during job execution and be
certified and approved by bpc fire and
bomba dept and be endorse competency in
BPC Safety passport
9.2.4 - Placed fire extinguisher at work site with
valid inspection sticker by BPC. Fire and
Bomba dept
9.2.5 - Spark Arrester should be installed at the
machine
9.2.6 - lEL must be checked by operations before
work start and it must show 0%
10.1.1 REFER TO THE GENERIC LIFTING JSA-
LIFTING USING CRAN
11.1.1 REFER TO THE GENERIC LIFTING JSA-
LIFTING USING CRANE
11.2.1 - Buddy system
11.2.2 - Make sure body posture in correct position
11.2.3 - Rotate worker and comply BPC fatigue
management
12.1.1 - Apply Excavation Permit
12.1.2 - Competence or certified backhoe
12.1.3 - Make sure working area free from
pedestrian and warning sign display.
12.1.4 - Traffic controller/signalman with
signalman west must be at site and control
traffic when execution the job.
12.1.5 - Material and tool is stack and keep at safe
place and proper storage.
12.1.6 - Make sure machinery/vehicle been
inspected by BPC to have a valid inspection
sticker.
12.1.1 - Run an underground test/detection before
starting work to make sure no electrical
cable underground or pipe.
12.1.2 - Attached a scanning report to JSA and
PTW
12.1.2 - Stop work immediately if underground
cable or pipe is found during excavation
work
12.3.1 - Install hard barricade and put warning
signage around the excavate area
12.3.2 - Material and tool is stack and keep at safe
place and
proper storage.
12.3.3 - Provision for temporary shoring/strutting.
12.4.1 - Workers to wear semi-leather glove
12.4.2 - Remove blunt or sharp object from work
area
12.4.3 - Make sure hand/body position not in pinch
point location.
12.4.4 - Ensure housekeeping done
13.1.1 - Provide a proper vision for workers that
are working at night. Portable spot light

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 must be used at site while working
13.1.1 - Spotlight must be inspected and be given
valid inspected sticker by BPC Electrical
team
13.1.2 - Visual inspection by UBF Team must be
given to the portable light before the
commencement of work.
13.2 Ergonomics 13.2.1 - Adequate interval rest at rest area
13.2.2 - Workers rotation
13.2.3 - Ensure buddy systems are used if it is
exceeding 25kg
13.2.4 - Fatigue management, cannot exceed Six (6)
working days and maximum 12 hours per
days
14 Housekeeping 14.1 Slip, trip and fall 14.1.1 - Housekeeping to be maintained before,
during and after work.
14.1.2 - Proper Cable management
14.2 Ergonomics 14.2.1 - Manual lifting only for small and light
material not more than 25kg per person.
14.2.2 - Make sure body posture in correct position
14.2.3 - Rotate worker and comply BPC fatigue
management
14.2.4 - Buddy system
15 Close PTW 15.1 PTW not close 15.1.1 - Adherence to all 11 First Rules
15.1.2 - Make sure housekeeping is done before
close PTW
15.1.3 - RA to make sure already checked and
satisfied with the work area before closing
the PTW
15.1.4 - Return PTW to the area owner With JSA
and Site Safety Briefing Form.
15.1.5 - Inform the job status to LG2.0 team and
area owner (Aroma)

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SECTION B: SAFETY EQUIPMENT REQUIRED FOR THE JOB
Item Yes No Item Yes No Item Yes No Item Yes No
√
Safety Helmet √ Glove type: general glove √ Warning Signage √ Barricade
Safety Glasses √ Protective Suit type: ______ √ Fire Extinguisher type: ABC √ LEL Detector √
Safety Shoes √ Rain Boot / Plastic Boot √ Ladder √ Continuous CO Monitor √
Face shield √ Safety Harness √ Work Vest √ Trefoil Symbol √
Mono goggle √ Ear Muff / Ear Plug √ Rain Coat √ Lock-Out/Tag-Out √
Respirator type: N95
JSA Leader (Name/Sign/Date): JSA Members (Name/Sign/Date)
1) 6)
2) 7)
JSA Approver (Name/Sign/Date): 3) 8)
4) 9)
5) 10)
Note: All JSA must be signed by the Team Members, JSA Team Leader and Approved by JSA Approver
SECTION C: Requirement for CONFINED SPACE Activity
1 Name of the equipment / vessel to be worked in
2 Maximum personnel allowed to be in the confined space
3 Associated hazards and mitigations
4 Entry Points
5 Means of ventilation
6 Atmospheric monitoring requirement (frequency)
7 Emergency Response additional requirements (Emergency Response Plan)
8 Means of communications

SECTION D: Requirement for ELECTRICAL HAZARD identification

Types of electrical hazard Yes / No? Control measures
1 Live underground cable
2 Live exposed terminals
3 Live control voltage (110V DC/230V AC)
4 Residual charge
5 Others:

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